Program Overview: The Innovative Curriculum
 The goal of our residency program is to train excellent physicians who become leaders in health care.
To accomplish this goal, our program has structured a curriculum that
(1) integrates the educational features necessary to develop the lifelong skills and knowledge that effective leaders in health care need,
regardless of their specialty, and (2) enlists our talented faculty, many of whom are leaders themselves in their
own fields, to impart their knowledge and experiences to the housestaff. The program's curriculum seamlessly integrates various educational features that come in sundry forms
and include but are not limited to conferences, scholarly projects, procedural training,
Internet-based learning, and leadership training. The
innovative curriculum, combined with training at world-class hospitals with diverse patient populations and distinguished faculty, places our program among the best in the country.
The field of medicine is an ever-evolving entity. Our program and its curriculum undergo a continuous review process by residents and faculty.
This allows us to adjust to this dynamic by making necessary modifications to meet the demands of training physician leaders for the
21st century.
The innovative curriculum includes the components necessary to train residents with the specific knowledge, skills, and attitudes required to master the six core competencies as outlined by the Accreditation Council for Graduate Medical Education (ACGME):
- Patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
- Medical knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
- Practice-based learning and
improvement that involve
residents in investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care
- Interpersonal and communication
skills that result in effective information exchange and teaming with patients, their families, and other health professionals
- Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
- Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value
While espousing the ACGME's philosophy of what it takes to train sensitive, thoughtful, and competent physicians, we also believe our program transcends this mission by training physicians who become leaders in health care whether it is in education, research, a subspecialty, or the community.
The curriculum features a variety of conferences that draw from the many general and subspecialty experts here at the University of Pittsburgh Medical Center as well as from other national and international institutions. The breadth of topics and depth of content make these scholarly meetings a backbone of the residency training.
Training Tomorrow's Teachers and Leaders: Resident Retreats
We believe that the best training experience depends on giving physicians graded responsibility during their years of training. First-year residents are considered to be their patients' primary physician, and they develop their therapeutic plans, write their orders, and make decisions about their care under the careful supervision of a junior or senior resident and a faculty attending physician. As residents progress through the program
and attain greater patient responsibilities and independence, they become team educators and leaders.
Each first-year resident participates in the Professionalism Retreat,
which focuses on
the development of leadership skills and on the professional and ethical responsibilities of a physician.
Before the start of the second year, first-year residents enrolled in one of the
3-year programs take part in the Learning to
Be a Resident Retreat. Residents are educated
about the principles of cognitive learning
theory and experiential learning theory in an effort to help them structure a learning environment for future first-year residents and medical students under their tutelage. Other topics include running a successful team, resolving conflicts, and optimizing communication skills. The third retreat occurs later in the second year to reassess and build on previous concepts.
Evidence-Based Medicine
 The principles of evidence-based medicine are integral to the program's curriculum. The broad goal is to improve patient care by moving residents from an experience-based form of clinical practice to one informed by the systematic application of medical knowledge. The concepts
of evidence-based medicine are peppered throughout the curriculum and reinforced in various didactic exercises as well as in clinics and on the wards. Although our program is devoted to educating our residents on the importance and implementation of
these concepts, we also recognize the importance of training physicians to recognize patients as individuals who may have special circumstances in which a physician's medical judgment should override the systematic application of
the principles of evidence-based medicine.
Resident Journal Club
First-year residents are introduced to evidence-based medicine during their work on the wards and
in clinics. Second- and third-year residents participate in Resident Journal Club, a monthly series
that formally introduces them to the core concepts of evidence-based medicine. Emphasis is placed on developing an answerable, focused clinical question, reviewing a relevant article from the medical literature, appraising the article, and answering the clinical question in
a manner that allows it to be applied to clinical practice.
Typically, the resident chooses an article on a topic inspired by an actual patient scenario that he or she has experienced. Residents are taught the relevant statistical methods and appropriate calculations that are necessary for considering the importance of the article. They then summarize the clinical scenario, answerable clinical question, literature search, and critical appraisal in the form of a
critically appraised topic (CAT), a 1-page summary of the project. A secondary goal of Resident Journal Club is the compilation of CATs
that can be archived and readily accessed by other residents. Please click here for three sample CATs generated by our residents over the last year.
Senior Presentation
The Senior Presentation is a scholarly project required by
each third-year resident. It is a chance
for the resident to implement and showcase the evidence-based medicine concepts
that he or she has learned in Resident Journal Club and throughout residency. The main elements and concepts of the
project are the same as those used to evaluate an article in Resident Journal Club meetings except
that this time the resident applies them to a body of literature on a particular topic.
The resident
works on this project over the course of 3-6 months with the aid of a faculty mentor of choice.
The subject matter for this project may stem from the resident's clinical experiences, research
interests, or involvement in a scholarly project
that is part of the resident's program
track or pathway. The project culminates when the resident gives a formal presentation of
findings to the housestaff and faculty as part of the Core Medical Conference Series. Each year, the two
best presenters receive a monetary award and are invited to formally present their topic at
Medical Grand Rounds.
Web-Based Computer Modules
 As part of a comprehensive approach to learning, residents and interns complete a series of didactic, case-based, pre-clinic
Internet modules that are guided by the concepts of evidence-based medicine. Each case has been carefully chosen and designed to highlight key concepts of patient care in the ambulatory medicine setting. Sample topics include professionalism, hypertension,
medical complications of pregnancy, tobacco cessation, and systems-based practice.
Medical Procedure Training
WISER Simulation Training
The Peter M. Winter Institute for Simulation, Education, and Research (WISER), one of the most advanced and active medical simulation centers in the country, uses sophisticated educational technology to provide hands-on training for internal medicine interns and residents and other health care professionals. Click here to view the WISER Institute video.
Interns are enrolled in the Central Venous Cannulation Training
Course, where they learn to develop the skills necessary to place internal jugular, subclavian, and femoral central lines using life-like simulation systems and portable ultrasound, under close faculty supervision. Second-year residents participate in the Crisis Training Course, which teaches teams of medical professionals to complete a rapid-order set of tasks that would be necessary to save a life in a "code" situation.
The WISER Center also serves as the training site for Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). For residents interested in learning more, the
center also offers classes in airway management, simulated code training, and many other
topics.
Code and Emergency Procedure Training
Some of the scariest moments in the life of a house officer occur during code situations when a patient is crashing and you're the only one there. Fortunately, our hospitals have rapid-response teams that respond to all non-ICU codes 24 hours a day. However, to make residents more comfortable and effective in participating and managing codes, our program has developed the Code/Procedure Elective. It is the first of its kind in the country, designed specifically for residents.
Each resident serves as one of the members of an attending-led rapid-response team participating in placement of central lines, intubations, and even overall management of the codes as the resident becomes more adept and confident. Residents spend part of their time participating in supervised simulated codes using one of the WISER
simulation mannequins. Finally, residents on this elective attend Crisis Quality Improvement Review, a weekly meeting
that is held by the Critical Care Medicine Department
to review all codes over the prior week in an effort to streamline responses, educate responders, and identify and correct errors.
A second aspect of this elective is still in development but will encompass a review of non-emergent bedside and office-based procedures. Topics to be covered include microscopic analysis of various body fluids (urine, joint fluid, etc.); suturing; skin biopsies; arthrocentesis; and several other
procedures.
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